Managed Care

RECIPIENTS ELIGIBLE FOR ENROLLMENT IN MANAGED CARE:ENROLLMENT STATUS BY AID CATEGORY AND COUNTY,AND TOTAL PERCENT ENROLLED BY PROVIDER PLAN

NYS September 2003

TANF ADC & MA-ADC

SNA HR & MA-HR

TANF & MA-ADC, SNA & MA-HR

EXPECTED PENETRATION RATE

SSI & MA-SSI

County

Provider

Eligibles

Enrolled

Eligibles

Enrolled

Total Eligibles

Total Enrolled

Percent Enrolled

Expected Target*

% of Target*

Eligibles

Enrolled

Total Eligibles

Total Enrolled

Percent Enrolled

Albany

TOTALS:

17,057

14,471

2,020

1,183

19,077

15,654

82%

92%

89%

4,370

956

23,447

16,610

71%

Mandatory

CDPHP

11,814

911

12,725

67%

836

13,561

58%

Fidelis/NYS Catholic Hlth

1,643

200

1,843

10%

80

1,923

8%

Wellcare

1,014

72

1,086

6%

40

1,126

5%

Allegany

TOTALS:

3,620

1,087

348

76

3,968

1,163

29%

90%

32%

987

197

4,955

1,360

27%

Voluntary

Health Choice (Partial)

313

31

344

9%

156

500

10%

HealthNow/BCBS-WNY/Community Blue

774

45

819

21%

41

860

17%

Broome

TOTALS:

13,263

11,433

1,325

957

14,588

12,390

85%

90%

94%

3,561

988

18,149

13,378

74%

Mandatory

Broome MC

4,800

331

5,131

35%

711

5,842

32%

CDPHP

6,229

581

6,810

47%

256

7,066

39%

Fidelis/NYS Catholic Hlth

404

45

449

3%

21

470

3%

Cattaraugus

TOTALS:

6,269

4,909

422

324

6,691

5,233

78%

91%

86%

1,525

640

8,216

5,873

71%

Mandatory

Fidelis/NYS Catholic Hlth

1,040

75

1,115

17%

79

1,194

15%

HealthNow/BCBS-WNY/Community Blue

3,869

249

4,118

62%

561

4,679

57%

Cayuga Voluntary

TOTALS:

5,370

0

334

0

5,704

0

0%

89%

0%

1,145

0

6,849

0

0%

Chautauqua

TOTALS:

12,843

9,773

1,554

1,103

14,397

10,876

76%

85%

89%

2,709

1,150

17,106

12,026

70%

Mandatory

Fidelis/NYS Catholic Hlth

5,654

618

6,272

44%

550

6,822

40%

HealthNow/BCBS-WNY/Community Blue

3,509

364

3,873

27%

359

4,232

25%

Primary Health

610

121

731

5%

241

972

6%

Chemung

TOTALS:

8,486

3,995

780

248

9,266

4,243

46%

89%

52%

1,955

927

11,221

5,170

46%

Voluntary

Southern Tier Pediatrics (Partial)

2,759

0

2,759

30%

260

3,019

27%

Southern Tier Priority (Partial)

1,236

248

1,484

16%

667

2,151

19%

Chenango Voluntary

TOTALS:

4,787

0

244

0

5,031

0

0%

92%

0%

994

0

6,025

0

0%

Clinton Voluntary

TOTALS:

5,738

0

469

0

6,207

0

0%

86%

0%

1,572

0

7,779

0

0%

Columbia

TOTALS:

3,160

2,575

263

177

3,423

2,752

80%

93%

86%

869

210

4,292

2,962

69%

Mandatory

CDPHP

2,019

138

2,157

63%

175

2,332

54%

Fidelis/NYS Catholic Hlth

194

14

208

6%

7

215

5%

Wellcare

362

25

387

11%

28

415

10%

Cortland

TOTALS:

4,220

418

282

20

4,502

438

10%

91%

11%

766

80

5,268

518

10%

Voluntary

Fidelis/NYS Catholic Hlth

418

20

438

10%

80

518

10%

Delaware

TOTALS:

2,870

102

219

5

3,089

107

3%

92%

4%

743

3

3,832

110

3%

Voluntary

Wellcare

102

5

107

3%

3

110

3%

Dutchess

TOTALS:

9,392

2,037

790

92

10,182

2,129

21%

90%

23%

2,764

126

12,946

2,255

17%

Voluntary

Wellcare

2,037

92

2,129

21%

126

2,255

17%

Erie

TOTALS:

66,731

54,836

8,821

5,265

75,552

60,101

80%

93%

86%

17,135

7,627

92,687

67,728

73%

Mandatory

Buffalo Community Health

8,168

650

8,818

12%

352

9,170

10%

Fidelis/NYS Catholic Hlth

14,258

808

15,066

20%

1,346

16,412

18%

HealthNow/BCBS-WNY/Community Blue

12,621

1,179

13,800

18%

1,009

14,809

16%

Independent Health Assoc/IHA

19,105

1,512

20,617

27%

1,638

22,255

24%

Total Full Risk

54,152

4,149

58,301

77%

4,345

62,646

68%

PCMP II (Partial)

99

33

132

0%

267

399

0%

PCMP III (Partial)

5

18

23

0%

278

301

0%

PCMP II-A Special Care (Partial)

580

1,065

1,645

2%

2,737

4,382

5%

Total Partial Risk

684

1,116

1,800

2%

3,282

5,082

5%

Essex Voluntary

TOTALS:

2,054

0

145

0

2,199

0

0%

92%

0%

583

0

2,782

0

0%

Franklin Voluntary

TOTALS:

3,478

0

278

0

3,756

0

0%

91%

0%

993

0

4,749

0

0%

Fulton

TOTALS:

5,207

927

372

53

5,579

980

18%

92%

19%

1,080

43

6,659

1,023

15%

Voluntary

CDPHP

927

53

980

18%

43

1,023

15%

Genesee

TOTALS:

3,347

1,961

185

134

3,532

2,095

59%

89%

66%

617

123

4,149

2,218

53%

Voluntary

HealthNow/BCBS-WNY/Community Blue

714

56

770

22%

14

784

19%

Preferred Care

1,247

78

1,325

38%

109

1,434

35%

Greene

TOTALS:

3,080

2,677

257

170

3,337

2,847

85%

93%

91%

669

249

4,006

3,096

77%

Mandatory

CDPHP

1,817

117

1,934

58%

184

2,118

53%

Fidelis/NYS Catholic Hlth

308

19

327

10%

17

344

9%

Wellcare

552

34

586

18%

48

634

16%

Hamilton Voluntary

TOTALS:

211

0

14

0

225

0

0%

91%

0%

47

0

272

0

0%

Herkimer

TOTALS:

4,918

2,698

314

180

5,232

2,878

55%

92%

60%

898

70

6,130

2,948

48%

Mandatory

Excellus

758

50

808

15%

19

827

13%

Fidelis/NYS Catholic Hlth

1,200

90

1,290

25%

37

1,327

22%

United Healthcare of Upstate

740

40

780

15%

14

794

13%

Jefferson Voluntary

TOTALS:

8,461

0

721

0

9,182

0

0%

87%

0%

1,831

0

11,013

0

0%

Lewis Voluntary

TOTALS:

2,324

0

123

0

2,447

0

0%

93%

0%

425

0

2,872

0

0%

Livingston

TOTALS:

3,575

2,884

346

223

3,921

3,107

79%

92%

87%

675

195

4,596

3,302

72%

Mandatory

Excellus

1,968

137

2,105

54%

93

2,198

48%

Preferred Care

916

86

1,002

26%

102

1,104

24%

Madison Voluntary

TOTALS:

3,969

0

220

0

4,189

0

0%

91%

0%

769

0

4,958

0

0%

Monroe

TOTALS:

54,874

41,775

8,702

3,927

63,576

45,702

72%

91%

79%

12,472

3,081

76,048

48,783

64%

Mandatory

Excellus

31,548

3,023

34,571

54%

2,444

37,015

49%

Preferred Care

10,227

904

11,131

18%

637

11,768

15%

Montgomery

TOTALS:

4,274

884

386

36

4,660

920

20%

92%

22%

816

71

5,476

991

18%

Voluntary

CDPHP

884

36

920

20%

71

991

18%

Nassau

TOTALS:

34,739

29,412

3,380

1,861

38,119

31,273

82%

92%

89%

10,221

1,624

48,340

32,897

68%

Mandatory

Affinity Health Plan

5,930

220

6,150

16%

252

6,402

13%

Fidelis/NYS Catholic Hlth

4,461

234

4,695

12%

197

4,892

10%

HealthFirst PHSP

7,628

335

7,963

21%

306

8,269

17%

HIP

5,543

597

6,140

16%

516

6,656

14%

United Healthcare of NY

3,222

319

3,541

9%

188

3,729

8%

Vytra

2,628

156

2,784

7%

165

2,949

6%

Niagara

TOTALS:

13,849

12,492

1,559

1,060

15,408

13,552

88%

93%

95%

3,394

1,647

18,802

15,199

81%

Mandatory

Fidelis/NYS Catholic Hlth

2,318

225

2,543

17%

314

2,857

15%

HealthNow/BCBS-WNY/Community Blue

4,734

385

5,119

33%

460

5,579

30%

Independent Health Assoc/IHA

5,440

450

5,890

38%

873

6,763

36%

Oneida

TOTALS:

18,945

15,790

1,652

1,211

20,597

17,001

83%

92%

89%

5,309

1,586

25,906

18,587

72%

Mandatory

Excellus

1,980

206

2,186

11%

78

2,264

9%

Fidelis/NYS Catholic Hlth

8,770

706

9,476

46%

1,151

10,627

41%

United Healthcare of Upstate

5,040

299

5,339

26%

357

5,696

22%

Onondaga

TOTALS:

33,876

27,159

3,883

2,296

37,759

29,455

78%

89%

88%

7,987

2,397

45,746

31,852

70%

Mandatory

Excellus

2,483

267

2,750

7%

108

2,858

6%

Fidelis/NYS Catholic Hlth

5,898

502

6,400

17%

585

6,985

15%

Total Care/Syracuse PHSP

10,353

921

11,274

30%

1,098

12,372

27%

United Healthcare of Upstate

8,425

606

9,031

24%

606

9,637

26%

Ontario

TOTALS:

4,735

4,107

426

213

5,161

4,320

84%

91%

92%

1,142

405

6,303

4,725

75%

Mandatory

Excellus

3,368

162

3,530

68%

338

3,868

61%

Preferred Care

739

51

790

15%

67

857

14%

Orange

TOTALS:

27,083

8,505

2,122

463

29,205

8,968

31%

91%

34%

4,243

758

33,448

9,726

29%

Voluntary

Affinity Health Plan

5,865

274

6,139

21%

610

6,749

20%

Wellcare

1,558

80

1,638

6%

95

1,733

5%

Westchester PHSP/HealthSource/Hudson Health Plan

1,082

109

1,191

4%

53

1,244

4%

Orleans

TOTALS:

3,439

1,927

329

145

3,768

2,072

55%

92%

60%

591

118

4,359

2,190

50%

Mandatory

Excellus

672

44

716

19%

55

771

18%

Fidelis/NYS Catholic Hlth

837

65

902

24%

48

950

22%

HealthNow/BCBS-WNY/Community Blue

418

36

454

12%

15

469

11%

Oswego

TOTALS:

11,117

9,596

803

629

11,920

10,225

86%

92%

93%

1,926

659

13,846

10,884

79%

Mandatory

Excellus

223

32

255

2%

12

267

2%

Fidelis/NYS Catholic Hlth

1,899

144

2,043

17%

123

2,166

16%

Total Care/Syracuse PHSP

3,297

247

3,544

30%

267

3,811

28%

United Healthcare of Upstate

4,177

206

4,383

37%

257

4,640

34%

Otsego

TOTALS:

3,346

11

204

0

3,550

11

0%

91%

0%

849

0

4,399

11

0%

Voluntary

Wellcare

11

0

11

0%

0

11

0%

Putnam

TOTALS:

1,113

180

132

6

1,245

186

15%

88%

17%

563

30

1,808

216

12%

Voluntary

Care Plus Health Plan

180

6

186

15%

30

216

12%

Rensselaer

TOTALS:

9,173

8,033

961

742

10,134

8,775

87%

92%

94%

2,159

485

12,293

9,260

75%

Mandatory

CDPHP

6,563

578

7,141

70%

412

7,553

61%

Fidelis/NYS Catholic Hlth

688

39

727

7%

46

773

6%

HealthNow/BlueShield of NENY

533

103

636

6%

16

652

5%

Wellcare

249

22

271

3%

11

282

2%

Rockland

TOTALS:

24,094

22,467

1,302

852

25,396

23,319

92%

92%

100%

2,645

600

28,041

23,919

85%

Mandatory

Affinity Health Plan

1,713

126

1,839

7%

120

1,959

7%

Community Choice Hlth Plan

127

18

145

1%

12

157

1%

Fidelis/NYS Catholic Hlth

15,414

360

15,774

62%

261

16,035

57%

Wellcare

1,999

105

2,104

8%

53

2,157

8%

Westchester PHSP/HealthSource/Hudson Health Plan

3,214

243

3,457

14%

154

3,611

13%

St Lawrence Voluntary

TOTALS:

8,789

0

656

0

9,445

0

0%

91%

0%

2,559

0

12,004

0

0%

Saratoga

TOTALS:

6,737

5,519

429

321

7,166

5,840

81%

92%

89%

1,889

266

9,055

6,106

67%

Mandatory

CDPHP

4,689

247

4,936

69%

236

5,172

57%

Fidelis/NYS Catholic Hlth

661

51

712

10%

27

739

8%

HealthNow/BlueShield of NENY

139

19

158

2%

2

160

2%

Wellcare

30

4

34

0%

1

35

0%

Schenectady

TOTALS:

10,345

5,952

939

301

11,284

6,253

55%

90%

62%

2,599

729

13,883

6,982

50%

Voluntary

CDPHP

5,156

262

5,418

48%

670

6,088

44%

Fidelis/NYS Catholic Hlth

796

39

835

7%

59

894

6%

Schoharie

TOTALS:

2,039

66

147

7

2,186

73

3%

92%

4%

381

5

2,567

78

3%

Voluntary

CDPHP

66

7

73

3%

5

78

3%

Schuyler

TOTALS:

1,423

67

116

4

1,539

71

5%

92%

5%

310

2

1,849

73

4%

Voluntary

Southern Tier Priority (Partial)

67

4

71

5%

2

73

4%

Seneca

TOTALS:

2,122

1,452

144

60

2,266

1,512

67%

92%

72%

463

178

2,729

1,690

62%

Voluntary

Excellus

1,452

60

1,512

67%

178

1,690

62%

Steuben

TOTALS:

8,070

2,234

769

225

8,839

2,459

28%

91%

31%

2,070

651

10,909

3,110

29%

Voluntary

Southern Tier Pediatrics (Partial)

111

0

111

1%

15

126

1%

Southern Tier Priority (Partial)

2,123

225

2,348

27%

636

2,984

27%

Suffolk

TOTALS:

53,946

47,940

5,076

3,465

59,022

51,405

87%

91%

95%

13,448

2,976

72,470

54,381

75%

Mandatory

Affinity Health Plan

5,329

288

5,617

10%

190

5,807

8%

Fidelis/NYS Catholic Hlth

4,722

316

5,038

9%

158

5,196

7%

HealthFirst PHSP

7,514

412

7,926

13%

564

8,490

12%

HIP

6,063

884

6,947

12%

325

7,272

10%

Suffolk Health Plan

11,421

712

12,133

21%

1,170

13,303

18%

United Healthcare of NY

8,668

485

9,153

16%

248

9,401

13%

Vytra

4,223

368

4,591

8%

321

4,912

7%

Sullivan

TOTALS:

6,184

2,682

309

56

6,493

2,738

42%

91%

47%

1,493

153

7,986

2,891

36%

Voluntary

Wellcare

304

2

306

5%

36

342

4%

Westchester PHSP/HealthSource/Hudson Health Plan

2,378

54

2,432

37%

117

2,549

32%

Tioga

TOTALS:

3,130

92

218

5

3,348

97

3%

92%

3%

731

0

4,079

97

2%

Voluntary

CDPHP

92

5

97

3%

0

97

2%

Tompkins

TOTALS:

4,653

307

516

31

5,169

338

7%

90%

7%

1,005

26

6,174

364

6%

Voluntary

Total Care/Syracuse PHSP

307

31

338

7%

26

364

6%

Ulster

TOTALS:

9,395

2,312

852

77

10,247

2,389

23%

91%

26%

2,587

190

12,834

2,579

20%

Voluntary

Wellcare

2,312

77

2,389

23%

190

2,579

20%

Warren

TOTALS:

3,312

2,113

216

22

3,528

2,135

61%

92%

66%

922

75

4,450

2,210

50%

Voluntary

HealthNow/BlueShield of NENY

2,113

22

2,135

61%

75

2,210

50%

Washington

TOTALS:

3,942

1,643

213

42

4,155

1,685

41%

91%

45%

949

131

5,104

1,816

36%

Voluntary

CDPHP

561

6

567

14%

27

594

12%

Fidelis/NYS Catholic Hlth

13

0

13

0%

1

14

0%

HealthNow/BlueShield of NENY

1,069

36

1,105

27%

103

1,208

24%

Wayne

TOTALS:

4,943

4,284

292

212

5,235

4,496

86%

92%

93%

1,201

346

6,436

4,842

75%

Mandatory

Excellus

2,046

105

2,151

41%

152

2,303

36%

Preferred Care

2,238

107

2,345

45%

194

2,539

39%

Westchester

TOTALS:

49,427

35,621

6,706

3,046

56,133

38,667

69%

89%

78%

10,325

2,534

66,458

41,201

62%

Mandatory

Affinity Health Plan

5,288

438

5,726

10%

440

6,166

9%

Community Choice Hlth Plan

6,178

550

6,728

12%

445

7,173

11%

Fidelis/NYS Catholic Hlth

3,155

400

3,555

6%

225

3,780

6%

HIP

2,751

486

3,237

6%

320

3,557

5%

Westchester PHSP/HealthSource/Hudson Health Plan

18,249

1,172

19,421

35%

1,104

20,525

31%

Wyoming Voluntary

TOTALS:

1,908

0

116

0

2,024

0

0%

91%

0%

425

0

2,449

0

0%

Yates

TOTALS:

1,713

1,201

96

54

1,809

1,255

69%

93%

75%

288

93

2,097

1,348

64%

Voluntary

Excellus

1,201

54

1,255

69%

93

1,348

64%

Upstate Total

631,165

412,606

64,497

31,579

695,662

444,185

64%

91%

70%

147,644

35,400

843,306

479,585

57%

NYC

ABC Health Plan

7,091

1,497

8,588

1%

179

8,767

0%

Mandatory

Affinity Health Plan

72,552

15,152

87,704

5%

2,940

90,644

5%

AmeriChoice of New York/MHS

64,469

18,889

83,358

5%

3,205

86,563

5%

Care Plus Health Plan

53,368

8,649

62,017

4%

1,097

63,114

3%

Community Choice Hlth Plan

3,421

657

4,078

0%

78

4,156

0%

Community Premier Plus

35,741

6,606

42,347

3%

1,158

43,505

2%

Fidelis/NYS Catholic Hlth

63,107

11,603

74,710

5%

2,029

76,739

4%

Fidelis Care HealthierLife SN

HealthFirst PHSP

109,003

20,875

129,878

8%

5,004

134,882

7%

HealthFirst PHSP SN

5

4

9

0%

4

13

0%

Health Plus PHSP

122,522

24,376

146,898

9%

2,596

149,494

8%

HIP

114,121

38,088

152,209

10%

7,264

159,473

9%

Manhattan PHSP/CenterCare

54,953

10,831

65,784

4%

1,798

67,582

4%

MetroPlus Health Plan

110,882

22,571

133,453

8%

4,513

137,966

7%

MetroPlus Health Plan SN

27

23

50

0%

58

108

0%

Neighborhood Health Providers

59,107

8,954

68,061

4%

1,844

69,905

4%

NY Hospital Community PHSP

29,802

7,821

37,623

2%

863

38,486

2%

NYPS Select Health SN

0

4

4

0%

8

12

0%

St Barnabas/Partners in Health

17,662

3,154

20,816

1%

1,084

21,900

1%

United Healthcare of NY

20,210

8,263

28,473

2%

784

29,257

2%

VidaCare Inc. SN

0

6

6

0%

13

19

0%

Wellcare

19,390

4,478

23,868

1%

472

24,340

1%

NYC Total

1,232,048

957,433

365,179

212,501

1,597,227

1,169,934

73%

90%

81%

251,856

36,991

1,849,083

1,206,925

65%

UPSTATE TOTALS:

631,165

412,606

64,497

31,579

695,662

444,185

64%

91%

70%

147,644

35,400

843,306

479,585

57%

NEW YORK CITY TOTALS:

1,232,048

957,433

365,179

212,501

1,597,227

1,169,934

73%

90%

81%

251,856

36,991

1,849,083

1,206,925

65%

GRAND TOTALS

1,863,213

1,370,039

429,676

244,080

2,292,889

1,614,119

70%

91%

78%

399,500

72,391

2,692,389

1,686,510

63%

NYC Boroughs

Bronx

305,681

243,473

83,283

44,219

388,964

287,692

74%

64,760

9,791

453,724

297,483

66%

Brooklyn

456,460

355,656

140,056

88,200

596,516

443,857

74%

86,314

13,451

682,830

457,308

67%

Manhattan

175,007

124,756

69,160

31,847

244,167

156,602

64%

48,437

5,697

292,604

162,299

55%

Queens

261,844

206,700

64,935

42,990

326,779

249,690

76%

44,510

6,273

371,289

255,963

69%

Staten Island

33,056

26,848

7,745

5,245

40,801

32,093

79%

7,835

1,780

48,636

33,872

70%

Borough Total

1,232,048

957,433

365,179

212,501

1,597,227

1,169,934

73%

90%

81%

251,856

36,991

1,849,083

1,206,925

65%

NOTES:

The Managed Care eligible counts are based upon January, 2003 total eligibles adjusted for excluded populations. The counts include recipients who are exempt from mandatory enrollment. (See about statement for further details)

The source of plan enrollment counts was revised in July, 2003 to be based on the primary and secondary roster reports. The roster reports reflect enrollees as of the first the month. (See about statement for further details)

All percents are rounded to the nearest whole number.

The expected penetration rate columns reflect an adjustment to total eligibles and the percent enrolled to account for the portion of the exempt population who are expected to choose not to enroll in managed care and for retroactive Medicaid eligibility determinations precluding enrollment for the month being measured. (An exempt recipient is one who will not be mandated to enroll in Medicaid managed care, but is eligible to enroll voluntarily. This would include Medicaid recipients with AIDS, HIV or a serious and persistent mental illness. (See the about statement for further details of this adjustment).

New plans added this month: None

MANAGED LONG TERM CARE ENROLLMENT BY PROVIDER AND COUNTY

NYS September, 2003

PROVIDER

COUNTY

TOTAL ENROLLMENT

BROADLAWN HEALTH PARTNERS

NASSAU

422

Total

422

CO-OP CARE PLAN

NYC

514

Total

514

COMPREHENSIVE CARE MGT

NYC

1,008

WESTCHESTER

106

Total

1,114

EDDY SENIORCARE

SCHENECTADY

85

Total

85

ELANT CHOICE

ORANGE

72

Total

72

GUILDNET

NYC

1,816

Total

1,816

HOMEFIRST

NYC

1,032

Total

1,032

INDEP CARE SYSTEMS INC

NYC

531

Total

531

INDEP LIVING FOR SENIORS

MONROE

297

Total

297

LORETTO/INDEPENDENT LIVING SERVICES

ONONDAGA

217

Total

217

PARTNERS IN COMMUNITY CARE

ORANGE

99

ROCKLAND

26

Total

125

SENIOR HEALTH PARTNERS INC

NYC

141

Total

141

SENIOR NETWORK HEALTH

HERKIMER

12

ONEIDA

290

Total

302

TOTAL AGING IN PLACE

ERIE

41

Total

41

VNS CHOICE

NYC

3,120

Total

3,120

UPSTATE TOTALS:

1,667

NEW YORK CITY TOTALS:

8,162

GRAND TOTALS:

9,829

Note: The source of enrollment is based on the primary and secondary roster reports.